Suprapubic Cystostomy at Urological Emergency Unit of CHU-YO, Ouagadougou, Burkina Faso: Indications, Technique and Complications

Introduction: Cystostomy allows under certain circumstances deriving the urine. This is the most performed surgery in uro-andrological emergencies. Complications can occur. We aim to analyze the indications, technical aspects and complications of suprapubic cystostomies in the urological emergency unit at CHU-YO. Patients and Methods: Between October 2013 and May 2014 we conducted a prospective study of all patients who underwent suprapubic cystostomy. Results: 86 cases of cystostomy were noted or 77.5% of surgical procedures performed in uro-andrological emergency. All patients were male. The average age of patients was 52.5 years. The AUR represented 88.4% of indications. The prostate tumor represented 65.8% of the etiologies of AUR. The cystostomy was performed under local anesthesia in 87.2% of cases. Peritoneal gap was noted in 5.8%, parietal suppuration in 12.8%. A death by generalized acute peritonitis was noted in one case. Conclusion: Suprapubic cystostomy presents a non-negligible morbidity and mortality and must be mastered.

Acute Generalized Peritonitis Due to the Migration of a Ballpoint Pen from Bladder to Great Peritoneal Cavity: A Case Report

Foreign bodies of the bladder are rares. The presence of a foreign body in the bladder is often anecdotic. We report a case of acute generalized peritonitis due to migration of a ballpoint pen from bladder to great peritoneal cavity in a 17-year-old man. He was admitted for a peritoneal syndrome after introducing a ballpoint pen into the urethra to masturbation purposes. He has no psychiatric history. Exploration had found an agglutination of small bowel loops around the ballpoint pen. The ballpoint pen was about 13.5 cm long and was transfixing the small intestine. We had noted about 20 cm of ileal necrosis about 30 cm from the ileocecal junction. An exit port was located at the posterior wall of the bladder. We performed a resection of the necrotic portion followed by end-to-end anastomosis. Bladder foreign bodies can have serious complications such as the formation of an acute surgical abdomen after migration of the foreign body. The extraction must be quickly carried as soon as the diagnosis is made to avoid these complications.

From Traditional Management of Mental Illness to Self-Mutilation of the Penile: A Case Report

Introduction: Self-mutilation of the external genitalia is rare. It occurs most often on a psychotic ground. Case Report: Mr. P.O. 25-year-old, a dress maker, admitted to the urological emergency for self-section of the penile. The patient had cut his penile with a razor blade and the amputated distal extremity had been thrown in the water closet. The patient was admitted 19 hours after the act of self-harm. Clinical examination had found a stable hemodynamic status, a section of the penile at its root. Psychiatrically schizophrenia evolving for 08 months was diagnosed. An attempt of penile reconstruction was performed. The patient benefited serum and tetanus vaccine, antibiotic and neuroleptics. The parents asked to go home against medical advice the 5th day. Conclusion: The management of self-mutilation of external genitalia is multidisciplinary including surgery and psychiatry.

Trauma of External Genitalia by Firearm: Therapeutic Strategy and Result, about a Case at CHU-YO, Ouagadougou, Burkina Faso

Introduction: Ballistic traumas of the external genitalia are rare especially in civil practice. Emergency surgical exploration is the rule. Case Report: Mr. F.Y., 29 years old, a security agent, admitted to the Urological Emergency Unit of Yalgado Ouédraogo University Hospital of Ouagadougou for trauma of the penile and left purse by firearm. The clinical examination revealed a good hemodynamic status, bladder distension. A suprapubic catheterization was performed. We noted a transfixing and bleeding wound on the penile, and on the left purse which was edematous. The patient was admitted to the operation room 07 hours after trauma. Exploration found a total destruction of the left testicle classified grade 5 of the classification of the American Association of the Surgery of Trauma (AAST). We performed a left orchiectomy. There was a partial rupture of the ventral face of the penile urethra. We performed an end-to-end anastomosis on a Foley catheter CH 18. The Foley catheter was removed after two weeks. Urination was spontaneous without dysuria. Erections were painless and without kinking of penile. Conclusion: Open traumas of the external genitalia are rare and their treatment is an extreme surgical emergency.

Infected Vaginal Hydrocele Due to a Septic Puncture-Aspiration: A Series of Seven Cases Collected at Yalgado Ouedraogo Teaching Hospital of Ouagadougou

Objective: To describe diagnostic and therapeutic outcomes of infected vaginal hydrocele.Material and Methods: This is a retrospective descriptive study over a period of two years from June 2013 to May 2015 at the urological emergency department of Yalgado Ouédraogo University Hospital (CHU-YO). Results: We collected seven cases during the period of study. The average age of patients was 35 years. Two patients (2/7) were from urban and five from rural areas. Five patients (5/7) were married and two (2/7) unmarried. Six patients (6/7) were farmers and one (1/7) was civil servent. Clinical examination findings were dominated by bilateral painful scrotal swelling and fever in all cases, a scrotal necrosis in two cases. The dominant indication of the puncture-aspiration was discomfort during sexual intercourse (5/7). At the opening of the scrotum purulent fluid was aspirated in all cases, and we performed a unilateral orchidectomy in two cases. A hydrocelectomy was performed in all cases. The postoperative evolution was simple in all patients. Conclusion: The puncture-aspiration must be avoided because the risk of infection and the high recurrence rate.